Out-of-hours hospital doctors are being tracked using the latest technology in a bid to help them become more efficient and improve patient care.
The project being led by experts at The University of Nottingham is using indoor navigation technology — based on a similar principle to the ’satnav’ — to study the footfall of medical staff both while working on wards and ‘in transit’ around the hospital during evenings and weekends.
The Wayward research project, led by Dr James Pinchin at Horizon Digital Economy Research, is also examining the way in which junior doctors deal with patient care-related tasks compared to more senior colleagues.

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The results could pave the way for improving hospital layout to make them easier and quicker to navigate. They are also expected to highlight areas where further training is needed for junior doctors.

Stressful environment

The project goes to the heart of national concerns about 24-hour staffing levels and expertise and comes as NHS England recently proposed that senior doctors and key diagnostic tests should be available seven days a week to tackle higher death rates at the weekend.

Dr Pinchin said: “Hospitals operate an ‘out of hours’ service for 75 per cent of the week, with a small number of doctors covering a very large number of patients. Typically during evenings and weekends in hospital there will be between five and seven doctors covering up to 24 wards.

“Consequently, these doctors are very busy people who are working in a stressful environment, performing complex tasks and making difficult decisions on how to prioritise patient care. Add in to the mix the fact that they are simultaneously navigating a large, often unfamiliar site to locate wards, patients, staff and equipment. This research is aimed at reducing doctor fatigue and increasing efficiency.”

The researchers are working on the project in partnership with Nottingham University Hospitals NHS Trust at their City Hospital and Queen’s Medical Centre campuses.

In a pilot study staff are wearing devices which use WiFi signals and inertial sensors to determine their position as they move through the corridors and wards. The study will look at how long it takes staff to move between different points and whether delays are occurring because of time taken to find vital locations and resources such as intravenous fluid sets and crash carts.

The project also uses data gathered from the award-winning Hospital at Night system which has replaced the traditional doctor paging. Launched at Nottingham University Hospitals NHS Trust, it has now been rolled out at hospitals in other parts of the UK.

The system, which was devised by University academics working in the Division of Respiratory Medicine, uses wireless smart devices to log requested tasks and tracks when jobs have been completed. It also improves the quality and accuracy of handovers between doctors. Research into its effectiveness found it led to a 70 per cent drop in ‘adverse incidents’ at Nottingham City Hospital over a six month period.

Using information recorded using the new digital system, the Horizon researchers are analysing how doctors prioritise their tasks and respond to their workload.

Complex issue

Dr Pinchin added: “Here at Horizon we are very interested in harnessing data to understand how people plan their time and tasks at work. Hospital at Night is already generating a lot of data which we can use in this way.

“For example, we have already observed that senior staff may be better at prioritising their workload and that they maintain their level of performance throughout a night shift, performing the same number of tasks at 3am as they would at 10am. This type of information could be used to inform training for less experienced staff.”

The study is also assessing the potential usefulness of an app called Doctor Sat Nav which can be added to the smart devices used by doctors as part of the Hospital at Night scheme. It would work in a similar way to an in-car sat nav system but would give them more accurate directions to locations such as wards and nurses stations.

The results could also be incorporated into more intelligent designs for hospitals such as devising standard ward layouts and improving signage aimed specifically at medical staff rather than just visitors.

Dr Dominick Shaw, one of The University of Nottingham academics who devised the Hospital at Night system and lead for out of hours care at Nottingham City Hospital, said: “This research goes to the heart of an issue which is of vital importance to both the NHS and healthcare providers. Maintaining an excellent standard of patient care 24 hours a day, seven days a week is an extremely complex issue for hospitals. New resources or strategies which could improve quality and effectiveness of the care provided are invaluable and especially important at this time of budgetary constraint.”

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Notes to editors: The University of Nottinghamhas 43,000 students and is ‘the nearest Britain has to a truly global university, with campuses in China and Malaysia modelled on a headquarters that is among the most attractive in Britain’ (Times Good University Guide 2014). It is also the most popular university among graduate employers, the world’s greenest university, and winner of the Times Higher Education Award for ‘Outstanding Contribution to Sustainable Development’. It is ranked in the World's Top 75 universities by the QS World University Rankings.